Active NPI
Jay Luke Lucas, M.D.
- Specialist
- Florence, SC
National Provider Identifier
1467404301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 9934
- Practice address
- 1540 American Dr
Florence, SC 29505-6072 - Phone
- (843) 317-9999
- Fax
- (843) 317-1996
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 9934 | SC | Primary |
Addresses
Primary practice location
1540 American Dr
Florence, SC 29505-6072
Mailing address
1540 American Drive
Florence, SC 29505
Phone (843) 317-9999
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02-0654505 | Other | SC | BLUE CROSS BLUE SHIELD |
| GP3611 | Medicaid | SC | |
| 10-00541 | Other | RI | CAROLINA CARE PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 1, 2019 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9934 | SC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579651200000",
"number": "1467404301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1540 AMERICAN DRIVE",
"city": "FLORENCE",
"state": "SC",
"postal_code": "29505",
"telephone_number": "843-317-9999",
"fax_number": "843-317-1996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 AMERICAN DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295056072",
"telephone_number": "843-317-9999",
"fax_number": "843-317-1996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JAY",
"middle_name": "LUKE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2020-01-22",
"certification_date": "2020-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "9934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "02-0654505",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP3611",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAROLINA CARE PLAN",
"identifier": "10-00541",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.